Twelve Bronx Nurses Laid Off After Hospital Replaces Them With AI Software
Montefiore Medical Center cut a dozen nurses whose job was reviewing patient insurance claims, handing that work to an automated system. Their union says the move broke a contract won through a recent strike.
Key points
- Montefiore Medical Center, a hospital in the Bronx, New York City, laid off 12 nurses on Sunday after replacing them with AI-powered software.
- The affected nurses worked in "utilisation review," reading patient charts and negotiating with insurance companies over whether treatments would be covered.
- The New York State Nurses Association, the union representing those nurses, says the layoffs violate a contract the nurses won through a strike.
- One of the laid-off nurses, Marilyn Shuler, had worked in the same role at Montefiore for 39 years.
Marilyn Shuler spent 39 years doing a job most patients never see but deeply depend on. As a utilisation review nurse, a role that involves reading patient charts and arguing with insurance companies over whether a treatment should be covered, she sat at the junction between medical care and paperwork. Last Sunday, Montefiore Medical Center told her and 11 colleagues they were no longer needed.
The hospital had replaced them with AI-powered software, an automated system designed to handle that same insurance review work without human nurses.
The New York State Nurses Association (NYSNA), the union that represents Montefiore nurses, says the move was illegal. The hospital recently settled a strike with the union, and the NYSNA argues the resulting contract protects these workers from exactly this kind of replacement. First reported by The Guardian, the dispute now sits at the centre of a much larger question: who is responsible when an AI system takes over a job that directly touches patient care?
Should patients be worried about AI handling their insurance reviews?
Yes, in practical terms, you should pay close attention to any insurance denial you receive from a hospital using automated review tools. Utilisation review is not a back-office formality. When a nurse in that role pushes back on an insurer, they bring clinical knowledge to the conversation. They know what a patient's chart actually says. An automated system applies rules; a trained nurse applies judgement.
If your treatment is denied and you are a Montefiore patient, ask explicitly whether the denial came from a human reviewer or an automated process. You have the right to appeal, and you may want your doctor to support that appeal in writing.
For workers, the Montefiore case is a clear signal. Hospitals are looking at AI tools to cut costs in administrative roles first, and clinical-adjacent positions like utilisation review sit squarely in that crosshairs. Unions with existing contracts should check now whether those agreements include language covering automation, not just traditional redundancy.
The NYSNA has not yet said whether it will pursue arbitration or legal action. Montefiore has not made a public statement addressing the contract dispute directly.
Shuler's 39 years carry weight here beyond the personal. That length of service means institutional knowledge: patterns in how insurers deny claims, relationships with staff, and the kind of contextual reading of a chart that no software yet reliably replicates. Whether the software Montefiore chose can match that is an open question. The hospital has not released any performance data or named the system it is now using.
